Metabolic Disorders, Osteoporosis and Fracture Risk in Asia: A Systematic Review.

PMs8 estiMating the iMPact of exPanDing access to celecoxib for osteoarthritis Patients in china Wang B.C.M.1, Xie X.P.2, Furnback W.1 1Alliance Life Sciences, Somerset, NJ, USA, 2Pfizer Inc., Beijing, China Objectives: Currently in China, celecoxib is prescribed to patients with gastrointestinal bleeding or perforation history. The aim of this study was to model the effect of expanding access to all osteoarthritis (OA) patients in China. MethOds: We created a one-year budget impact model from a payer perspective comparing two scenarios. The first scenario (A) restricts the use of celecoxib to only patients with gastrointestinal bleeding or perforation history while the second scenario (B) does not restrict usage. In (A), patients were prescribed either diclofenac or celecoxib, but those prescribed celecoxib were only dispensed celecoxib if they had gastrointestinal bleeding or perforation history. Those prescribed celecoxib but not fitting the criteria were dispensed diclofenac. In (B), all prescriptions were dispensed as written. For both scenarios, celecoxib and diclofenac prescriptions were written 16.2% and 8% of the time, respectively. Patients with gastrointestinal bleeding or perforation history made up 5.58% of the OA population. Celecoxib was associated with a 20% copay while diclofenac did not have a copay. The base case scenario assumes 13,333 patients. Results: Going from (A) to (B), the total cost of celecoxib increased ¥2,679,866 (94.42%) while the total cost of diclofenac decreased ¥1,817,170 (65.66%). The incremental total cost of drugs increased ¥862,697 (29.48%). The impact on a payer’s plans for the year was only due to drug costs since the cost to administer prior authorization was not considered. The per member per month increased ¥0.07 from ¥0.24 to ¥0.32. cOnclusiOns: The expanded access scenario (B) resulted in slightly higher drug costs to the payer, which may be acceptable under most thresholds. Patient outcomes should also be considered to fully understand the impact of removing the gastrointestinal bleeding and perforation history stipulation.